- In his State of the Union on speech Tuesday, President Trump called for a ban on “late-term abortion.”
- In his speech, he criticised the recent passage of a New York law that allows abortions after 24 weeks in cases of fetal anomalies or when a mother’s health is at risk.
- Experts say there are misunderstandings about abortions done later in pregnancy.
- These abortions are rare and typically happen for medical reasons, like fetal anomalies or conditions in which the mother’s health is threatened, Dr. Kristyn Brandi told INSIDER.
- “[It’s] really heartbreaking for people that have a desired pregnancy,” Brandi said. “They feel like it’s the only or the best option that they have.”
President Trump called on Congress to ban “late-term abortion of children who can feel pain” in his State of the Union speech on Tuesday night.
“Let us work together to build a culture that cherishes innocent life. And let us reaffirm a fundamental truth: all children – born and unborn – are made in the holy image of God,” he said.
In his remarks, Trump addressed the Reproductive Health Act, a New York state law passed last month that permits abortions after 24 weeks of pregnancy in cases when a mother’s health is at risk, or when the foetus isn’t viable. (Previously, the state’s law allowed abortions after 24 weeks only if the mother’s life was at risk, the Associated Press reported.)
“Lawmakers in New York cheered with delight upon the passage of legislation that would allow a baby to be ripped from the mother’s womb moments from birth,” Trump said, although the law only allows abortions after 24 weeks in certain cases. “These are living, feeling, beautiful, babies who will never get the chance to share their love and their dreams with the world,” Trump said.
In addition to the New York law, Trump also mentioned Virginia governor Ralph Northam, who was recently criticised after expressing support for a state bill that would have rolled back restrictions on third-trimester abortion when a mother’s physical or mental health was at risk.
“And then, we had the case of the Governor of Virginia where he stated he would execute a baby after birth,” Trump said.
Trump seemed to be referring to a radio interview Northam gave in January regarding the proposed Virginia bill. In the interview, Northam said that third-trimester abortions are done in cases where there may be severe fetal deformities or when a foetus is not viable. He then described a hypothetical scenario in which a baby would be delivered and that afterward, a “discussion would ensue between the physicians and the mother,” the New York Times reported.
In response to the interview, some Republicans accused Northam of supporting infanticide, the Associated Press reported. Ofirah Yheskel, the Governor’s spokesperson, later said that the governor was attempting to describe “tragic or difficult circumstances” that can lead to later abortion. “Attempts to extrapolate these comments otherwise is in bad faith and underscores exactly why the governor believes physicians and women, not legislators, should make these difficult and deeply personal medical decisions,” she said in a statement.
Together, the Virginia bill and the New York law the have ignited conversation on so-called “late-term” abortions, spurring outcry from some conservatives and anti-abortion advocates, the New York Times reported.
In an op-ed published in the National Review, for example, Vice President Mike Pence characterised the new law and the Virginia bill as the “shameless embrace of a culture of death.” In an interview with the BBC, Christina Fadden, chair of the anti-abortion organisation New York State Right to Life, said she was “extremely saddened” that New York’s new law passed, describing it as “horrific.” The Catholic bishops of New York State also released a statement criticising the law.
But medical professionals say that some opposition to “late-term” abortions relies on myths and misunderstandings about the procedure and why it’s typically done.
“Late-term abortion” isn’t a term doctors use
“Unfortunately, a lot of the politics around abortion are being [discussed] by people who aren’t from a medical background and don’t necessarily have the expertise around these issues, and using terms like ‘late-term’ is a great example of that,” Brandi told INSIDER.
“For me, when I hear ‘late-term,’ that refers to a pregnancy that is about a week after its due date,” she added. “I’m not sure why [this term] was adopted, and I think that leads to a lot of misinformation.”
Instead, she said, doctors typically describe these abortions in specific terms, noting exactly how far along a pregnancy is, or by using a phrase like “later in pregnancy.”
Dr. Daniel Grossman, an abortion and contraception researcher and director of Advancing New Standards in Reproductive Health, also addressed this terminology in a February 1 tweet, writing that “‘Late term abortion’ isn’t a medical term.”
Later abortions are not common
Data compiled by the Centres for Disease Control and Prevention (CDC) show that abortions occurring later in pregnancy are not common.
In 2015 (the most recent year for which data was available), 638,169 legal abortions were reported to the CDC. About 91% of those abortions were performed at or before 13 weeks of pregnancy, 7.6% were performed between 14 and 20 weeks, and just 1.3% were performed at 21 weeks or later. The percentage of later abortions has remained low since 2006, the CDC data show.
They typically happen for medical reasons
Some people opposing New York’s new law have argued that there are no medical reasons for later abortions. But doctors who have provided abortions disagree.
“This is an incredibly rare occurrence, but when it happens typically it’s either because [there is] some type of fetal anomaly that’s not consistent with survival after the foetus is delivered, or because something is going on in that patient’s health, and the further along they stay pregnant, more dangerous it is to their health,” Brandi said.
Brandi said fetal conditions that might indicate a later abortion include anomalies of the heart, brain, and lungs.
There are also some instances when pregnancy or pregnancy complications can threaten the mother’s health or life. One example, Brandi said, is when a pregnant person’s water breaks too early, which can lead to infection and sepsis, a life-threatening response to infection.
“There’s also things like high blood pressure that can worsen in pregnancy that can lead to a patient having a heart attack or a stroke or a fatal seizure,” she said. “People think of pregnancy as this natural process, but it can change a person’s body drastically, and in some people, it’s very dangerous to stay pregnant. In those cases sometimes terminating a pregnancy is the only thing that will save their life.”
In a recent viral thread on Twitter, gynecologist Dr. Jen Gunter also addressed medical reasons for abortions.
“I’ve done abortions after 24 weeks, she wrote. “I have never done one that was not medically indicated. I was never approached by any woman to do a non medically indicated abortion…Anyone, especially any doctor, who says these are not [medically] indicated is wrong.”
I’ve done abortions after 24 weeks.
For several years I lived in a state with no gestational age limit.
I have never done one that was not medically indicated.
I was never approached by any woman to do a non medically indicated abortion.
— Jennifer Gunter (@DrJenGunter) January 26, 2019
And in a subsequent blog post, Gunter railed against the idea that New York’s new law will result in more people casually seeking later abortions.
“This does not mean that ladies who just forgot their eight-week abortion who are now struggling to fit into their pants can get their better-late-than-never abortion,” she wrote. “It means doctors can do the right thing medically if the situation arises.”
Brandi also echoed this view.
“A lot of what I’ve heard in the media is that women are just going to flood in and try to seek abortions in the third trimester now that it’s legal. I don’t think people realise the individual scenarios that lead patients to make that decision.”
Finally, Brandi explained that abortion is a safe procedure.
“Typically, it’s actually safer than delivering a full term pregnancy for that patient,” she said.
Trump’s comments on fetal pain aren’t based on research, a doctor said
On Twitter, Grossman responded to Trump’s State of the Union, calling special attention to his claims about fetal pain.
“POTUS is calling for a national 20-week abortion ban based on ‘fetal pain’, however that’s not based in any research. Our best evidence-based research indicates a foetus cannot perceive pain until the third trimester, 26 weeks, not 20 weeks,” Grossman wrote, linking to a systematic review of evidence on fetal pain published in JAMA in 2005.
POTUS is calling for a national 20-week abortion ban based on “fetal pain”, however that's not based in any research. Our best evidence-based research indicates a fetus cannot perceive pain until the third trimester, 26 weeks, not 20 weeks. #SOTU https://t.co/PsoxO8nrsj
— Dr. Daniel Grossman (@DrDGrossman) February 6, 2019
“A foetus may have a reflex reaction to a painful stimulus by 18 weeks, but the neural connections to the cerebral cortex do not exist to allow the foetus to perceive this as pain,” Grossman wrote.
Later abortions can be ‘heartbreaking’ for people with wanted pregnancies
Brandi recalled one recent case in which a patient with a wanted pregnancy had a foetus with a heart anomaly. That anomaly would have prevented the foetus’s heart from pumping blood after birth, she said.
“Many patients that come to me for these indications, they’re doing what they can to have a humane outcome,” she said. “It’s really heartbreaking for people that have a desired pregnancy. They feel like it’s the only or the best option that they have.”
“It’s a really challenging decision and its something that patients need time to think about and deserve time to think about,” she added.
This post has been updated to include remarks made by President Trump during the State of the Union.
- Read more:
- 23 creative ways states are keeping women from getting abortions in the US – that could erode Roe v. Wade without repealing it
- There has been a disturbing rise in the maternal death rate in the US, and experts say it’s the most dangerous developed country to give birth in
- 10 of the most common pregnancy complications to watch out for
- A new service will help women in the US get the abortion pill by mail
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